Active NPI
Jennifer O'Dell, LPCC
- Professional Counselor
- Tompkinsville, KY
National Provider Identifier
1962623595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0578
- Practice address
- 201 E 2ND St
Suite B
Tompkinsville, KY 42167-1673 - Phone
- (270) 487-5655
- Fax
- (270) 487-5948
- NPI assigned
- May 1, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0578 | KY | Primary |
Addresses
Primary practice location
201 E 2ND St
Suite B
Tompkinsville, KY 42167-1673
Mailing address
609 Buck Creek Rd
Smiths Grove, KY 42171-9284
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30604011 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0578 | KY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifeskills, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Bowling Green, KY
- NPI 1669401816
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962623595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "609 BUCK CREEK RD",
"city": "SMITHS GROVE",
"state": "KY",
"postal_code": "421719284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 E 2ND ST",
"address_2": "SUITE B",
"city": "TOMPKINSVILLE",
"state": "KY",
"postal_code": "421671673",
"telephone_number": "270-487-5655",
"fax_number": "270-487-5948"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'DELL",
"first_name": "JENNIFER",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "KY",
"license": "0578",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30604011",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tompkinsville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.